Provider Demographics
NPI:1669707238
Name:CITY SMILES DENTAL SERVICES, P.C.
Entity type:Organization
Organization Name:CITY SMILES DENTAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-302-3112
Mailing Address - Street 1:620 W 42ND ST
Mailing Address - Street 2:APT 22J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-2014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:444 COMMUNITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3803
Practice Address - Country:US
Practice Address - Phone:516-302-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty